see AKI.
In hospital the possible need for urgent action is monitored by use of the GLASGOW COMA SCALE.
People suffering the results of such injuries and their relatives can obtain help and advice from Headway – the brain injury association.... head injury
Symptoms: short dry cough, catarrh, wheezing, sensation of soreness in chest; temperature may be raised. Most cases run to a favourable conclusion but care is necessary with young children and the elderly. Repeated attacks may lead to a chronic condition.
Alternatives. Teas – Angelica, Holy Thistle, Elecampane leaves, Fenugreek seeds (decoction), Hyssop, Iceland Moss, Mouse Ear, Mullein, Nasturtium, Plantain, Wild Violet, Thyme, White Horehound, Wild Cherry bark (decoction), Lobelia, Liquorice, Boneset. With fever, add Elderflowers.
Tea. Formula. Equal parts: Wild Cherry bark, Mullein, Thyme. Mix. 1 heaped teaspoon to cup water simmered 5 minutes in closed vessel. 1 cup 2-3 times daily. A pinch of Cayenne assists action.
Irish Moss (Carragheen) – 1 teaspoon to cup water gently simmered 20 minutes. It gels into a viscous mass. Cannot be strained. Add honey and eat with a spoon, as desired.
Tablets/capsules. Iceland Moss. Lobelia. Garlic. Slippery Elm.
Prescription No 1. Morning and evening and when necessary. Thyme 2; Lungwort 2; Lobelia 1. OR Prescription No 2. Morning and evening and when necessary. Iceland Moss 2; Wild Cherry bark 1; Thyme 2.
Doses:– Powders: one-third teaspoon (500mg) or two 00 capsules. Liquid Extracts: 30-60 drops. Tinctures: 1-2 teaspoons.
Practitioner. Alternatives:–
(1) Tincture Ipecacuanha BP (1973). Dose, 0.25-1ml.
(2) Tincture Grindelia BPC (1949). Dose, 0.6-1.2ml.
(3) Tincture Belladonna BP (1980). Dose, 0.5-2ml.
Black Forest Tea (traditional). Equal parts: White Horehound, Elderflowers and Vervain. One teaspoon to each cup boiling water; infuse 5-15 minutes; drink freely.
Topical. Chest rub: Olbas oil, Camphorated oil. Aromatherapy oils:– Angelica, Elecampane, Mullein, Cajeput, Lemon, Eucalyptus, Lavender, Mint, Onion, Pine, Thyme.
Aromatherapy inhalants: Oils of Pine, Peppermint and Hyssop. 5 drops of each to bowl of hot water.
Inhale: head covered with a towel to trap steam.
Diet: Low salt, low fat, high fibre. Halibut liver oil. Wholefoods. Avoid all dairy products. Supplements. Vitamins A, C, D, E. ... bronchitis, acute
The cortex contains specialized capillaries called glomeruli, which, together with a series of tubules, make up the nephrons, the filtering units of the kidney. The nephrons filter blood under pressure and then selectively reabsorb water and certain other substances back into the blood. Urine is formed from substances that are not reabsorbed. The urine is conducted through tubules to the renal pelvis (the central collecting area of the kidney) and then through tubes called ureters to the bladder.
The kidneys also regulate the body’s fluid balance.
To do this, the kidneys excrete excess water, and when water is lost from the body (for example as a result of sweating), they conserve it (see ADH).
In addition, the kidneys control the body’s acid–base balance by adjusting urine acidity.
The kidneys are also involved in hormonal regulation of red blood cell production and blood pressure.... kidney
The exact trigger is unknown, but it is thought that, whatever the stimulus, chemical mediators produced by cells of the immune system or elsewhere in the body spread and sustain an in?ammatory reaction. Cascade mechanisms with multiple interactions are provoked. CYTOTOXIC substances (which damage or kill cells) such as oxygen-free radicals and PROTEASE damage the alveolar capillary membranes (see ALVEOLUS). Once this happens, protein-rich ?uid leaks into the alveoli and interstitial spaces. SURFACTANT is also lost. This impairs the exchange of oxygen and carbon dioxide in the lungs and gives rise to the clinical and pathological picture of acute respiratory failure.
The typical patient with ARDS has rapidly worsening hypoxaemia (lack of oxygen in the blood), often requiring mechanical ventilation. There are all the signs of respiratory failure (see TACHYPNOEA; TACHYCARDIA; CYANOSIS), although the chest may be clear apart from a few crackles. Radiographs show bilateral, patchy, peripheral shadowing. Blood gases will show a low PaO2 (concentration of oxygen in arterial blood) and usually a high PaCO2 (concentration of carbon dioxide in arterial blood). The lungs are ‘sti?’ – they are less e?ective because of the loss of surfactant and the PULMONARY OEDEMA.
Causes The causes of ARDS may be broadly divided into the following:... acute respiratory distress syndrome (ards)
Adult kidneys have a smooth exterior, enveloped by a tough ?brous coat that is bound to the kidney only by loose ?brous tissue and by a few blood vessels that pass between it and the kidney. The outer margin of the kidney is convex; the inner is concave with a deep depression, known as the hilum, where the vessels enter. The URETER, which conveys URINE to the URINARY BLADDER, is also joined at this point. The ureter is spread out into an expanded, funnel-like end, known as the pelvis, which further divides up into little funnels known as the calyces. A vertical section through a kidney (see diagram) shows two distinct layers: an outer one, about 4 mm thick, known as the cortex; and an inner one, the medulla, lying closer to the hilum. The medulla consists of around a dozen pyramids arranged side by side, with their base on the cortex and their apex projecting into the calyces of the ureter. The apex of each pyramid is studded with tiny holes, which are the openings of the microscopic uriniferous tubes.
In e?ect, each pyramid, taken together with the portion of cortex lying along its base, is an independent mini-kidney. About 20 small tubes are on the surface of each pyramid; these, if traced up into its substance, repeatedly subdivide so as to form bundles of convoluted tubules, known as medullary rays, passing up towards the cortex. One of these may be traced further back, ending, after a tortuous course, in a small rounded body: the Malpighian corpuscle or glomerulus (see diagram). Each glomerulus and its convoluted tubule is known as a nephron, which constitutes the functional unit of the kidney. Each kidney contains around a million nephrons.
After entering the kidney, the renal artery divides into branches, forming arches where the cortex and medulla join. Small vessels come o? these arches and run up through the cortex, giving o? small branches in each direction. These end in a tuft of capillaries, enclosed in Bowman’s capsule, which forms the end of the uriniferous tubules just described; capillaries with capsule constitute a glomerulus.
After circulating in the glomerulus, the blood leaves by a small vein, which again divides into capillaries on the walls of the uriniferous tubules. From these it is ?nally collected into the renal veins and then leaves the kidney. This double circulation (?rst through the glomerulus and then around the tubule) allows a large volume of ?uid to be removed from the blood in the glomerulus, the concentrated blood passing on to the uriniferous tubule for removal of parts of its solid contents. Other arteries come straight from the arches and supply the medulla direct; the blood from these passes through another set of capillaries and ?nally into the renal veins. This circulation is con?ned purely to the kidney, although small connections by both arteries and veins exist which pass through the capsule and, joining the lumbar vessels, communicate directly with the aorta.
Function The kidneys work to separate ?uid and certain solids from the blood. The glomeruli ?lter from the blood the non-protein portion of the plasma – around 150–200 litres in 24 hours, 99 per cent of which is reabsorbed on passing through the convoluted tubules.
Three main groups of substances are classi?ed according to their extent of uptake by the tubules:
(1) SUBSTANCES ACTIVELY REABSORBED These include amino acids, glucose, sodium, potassium, calcium, magnesium and chlorine (for more information, see under separate entries).
(2) SUBSTANCES DIFFUSING THROUGH THE TUBULAR EPITHELIUM when their concentration in the ?ltrate exceeds that in the PLASMA, such as UREA, URIC ACID and phosphates.
(3) SUBSTANCES NOT RETURNED TO THE BLOOD from the tubular ?uid, such as CREATINE, accumulate in kidney failure, resulting in general ‘poisoning’ known as URAEMIA.... structure each kidney is about 10 cm long,
Symptoms: jaundice, delirium and convulsions.
As it is the work of the liver to neutralise incoming poisons it may suffer unfair wear and tear, alcohol and caffeine being common offenders.
Treatment for relief of symptoms only: same as for abscess of the liver.
Treatment by or in liaison with a general medical practitioner. ... liver – acute yellow atrophy
Urethritis is in?ammation of the urethra from infection.
Causes The sexually transmitted disease GONORRHOEA affects the urethra, mainly in men, and causes severe in?ammation and urethritis. Non-speci?c urethritis (NSU) is an in?ammation of the urethra caused by one of many di?erent micro-organisms including BACTERIA, YEAST and CHLAMYDIA.
Symptoms The classic signs and symptoms are a urethral discharge associated with urethral pain, particularly on micturition (passing urine), and DYSURIA.
Treatment This involves taking urethral swabs, culturing the causative organism and treating it with the appropriate antibiotic. The complications of urethritis include stricture formation.
Stricture This is an abrupt narrowing of the urethra at one or more places. Strictures can be a result of trauma or infection or a congenital abnormality from birth. Rarely, tumours can cause strictures.
Symptoms The usual presenting complaint is one of a slow urinary stream. Other symptoms include hesitancy of micturition, variable stream and terminal dribbling. Measurement of the urine ?ow rate may help in the diagnosis, but often strictures are detected during cystoscopy (see CYSTOSCOPE).
Treatment The traditional treatment was the periodic dilation of the strictures with ‘sounds’
– solid metal rods passed into the urethra. However, a more permanent solution is achieved by cutting the stricture with an endoscopic knife (optical urethrotomy). For more complicated long or multiple strictures, an open operation (urethroplasty) is required.... urethra, diseases of and injury to
It may arise from many causes, including physical influences (for example, force, heat, cold, electricity, vibration, and radiation), chemical causes (for example, poisons), bites, or oxygen deprivation.... injury
Kidney biopsy is performed to investigate and diagnose serious kidney disorders, such as glomerulonephritis, proteinuria, nephrotic syndrome, and acute kidney failure, or to assess the kidneys’ response to treatment.
There are 2 basic techniques: percutaneous needle biopsy, in which a hollow needle is passed through the skin into the kidney under local anaesthesia; and open surgery under general anaesthesia.... kidney biopsy
Acute toxic nephritis is possible in the convalescent stage of scarlet and other infectious fevers, even influenza. Causes are legion, including septic conditions in the ear, nose, throat, tonsils, teeth or elsewhere. Resistance to other infections will be low because of accumulation of toxins awaiting elimination. When protein escapes from the body through faulty kidneys general health suffers.
This condition should be treated by or in liaison with a qualified medical practitioner.
Treatment. Bedrest essential, with electric blanket or hot water bottle. Attention to bowels; a timely laxative also assists elimination of excessive fluid. Diuretics. Diaphoretics. Abundant drinks of bottled water or herb teas (3-5 pints daily). Alkaline drinks have a healing effect upon the kidneys. Juniper is never given for active inflammation.
Useful teas. Buchu, Cornsilk, Couchgrass, Clivers, Bearberry, Elderflowers, Marshmallow, Mullein, Marigold flowers, Wild Carrot, Yarrow.
Greece: traditional tea: equal parts, Agrimony, Bearberry, Couchgrass, Pellitory.
Powders. Equal parts: Dandelion, Cornsilk, Mullein. Dose: 750mg (three 00 capsules or half teaspoon) every 2 hours. In water or cup of Cornsilk tea.
Tinctures. Equal parts: Buchu, Elderflowers, Yarrow. Mix. Dose: 1-2 teaspoons in water or cup of Cornsilk tea, every two hours.
Topical. Hot poultices to small of the back; flannel or other suitable material saturated with an infusion of Elderflowers, Goldenrod, Horsetail or Yarrow. Herbal treatment offers a supportive role. ... bright’s disease (acute)
Urinalysis is a simple test in which a urine sample is examined under a microscope for blood cells, pus cells, and casts (cells and mucous material that accumulate in the tubules of the kidneys and pass into the urine).
Urine may be tested for substances, such as proteins, that leak into the urine when the kidneys are damaged.
Kidney function can be assessed by measuring the concentration in the blood of substances, such as urea and creatinine, that the kidneys normally excrete.
Kidney function may also be assessed by kidney imaging techniques.... kidney function tests
Formula. Corn Silk 3; Plantain (Plantago major L) 2; Golden Rod 1; Hydrangea 1; Valerian half. Dosage: thrice daily before meals. Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: two 00 capsules or one-third teaspoon. This may be used as a basic combination to be adapted to a changing clinical picture.
Treatment by a general medical practitioner or oncologist. ... cancer – kidney
Causes: smoking, mis-use of the voice in talking or singing (Ginseng).
Symptoms: voice husky or absent (aphonia). Talking causes pain. Self-limiting.
Treatment. Stop talking for 2 days. Care is necessary: neglect or ineffective treatment may rouse infection and invade the windpipe and bronchi resulting in croup.
Differential: croup is alerted by high fever and characteristic cough, requiring hospital treatment. Alternatives. Teas: Red Sage. Garden Sage. Thyme, wild or garden.
Effective combination: equal parts, Sage and Raspberry leaves. Used also as a gargle.
Tablets/capsules. Poke root. Lobelia. Iceland Moss.
Cinnamon. Tincture, essence or oil of: 3-5 drops in teaspoon honey.
Horseradish. 1oz freshly scraped root to steep in cold water for two hours. Add 2 teaspoons runny honey. Dose: 2-3 teaspoons every two hours.
Topical. Equal parts water/cider vinegar cold pack round throat. Renew when dry.
Traditional: “Rub soles of the feet with Garlic and lard well-beaten together, overnight. Hoarseness gone in the morning.” (John Wesley) Friar’s balsam.
Aromatherapy. Steam inhalations. Oils: Bergamot, Eucalyptus, Niaouli, Geranium, Lavender, Sandalwood.
Diet. Three-day fruit fast.
Supplements. Daily. Vitamin A (7500iu). Vitamin C (1 gram thrice daily). Beta carotene 200,000iu. Zinc 25mg. ... laryngitis, acute
More unusual forms of self-harm, such as mutilating the genitals, are usually due to psychosis. Self-destructive biting is a feature of Lesch–Nyhan syndrome, a rare metabolic disorder.... self-injury
Treatment. Bitter herbs keep the bile fluid and flowing.
Alternatives. Teas. Agrimony, Lemon Balm, Boldo, Bogbean, Centuary, Dandelion, Hyssop, Motherwort, Wormwood, Yarrow.
Maria Treben. Equal parts: Bedstraw, Agrimony, Woodruff. 2 teaspoons to cup boiling water.
Cold tea: 2 teaspoons Barberry bark to each cup cold water. Infuse overnight. Half-1 cup freely. Tablets/capsules: Blue Flag. Dandelion. Wild Yam. Liquorice.
Formula. Equal parts: Turkey Rhubarb, Dandelion, Meadowsweet. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). 3-4 times daily. Alfred Vogel. Dandelion, Devil’s Claw, Artichoke.
Antonius Musa, physician to Emperor Augustus Caesar records: “Wood Betony preserves the liver and bodies of men from infectious diseases”.
Preventative: Garlic. (Old Chinese)
Milk Thistle: good responses observed.
General. Bedrest until motions are normal. Enema with any one of above herb teas.
Diet. Fat-free. Fasting period from 1-3 days on fruit juices and herb teas only. Artichokes. Dandelion coffee. Lecithin.
See: COCKROACH, The.
Treatment by or in liaison with a general medical practitioner. ... liver – acute infectious hepatitis
In frostbite, an area of skin and flesh becomes frozen, hard, and white as a result of exposure to very cold, dry air.
Sometimes there is restriction of the blood supply to the affected area.
Another type of cold injury, immersion foot, occurs when the legs and feet are kept cold and damp for hours or days.
The main risk of both conditions is that blood flow will be slowed so much that the tissues will die, leading to gangrene.
Less serious forms of cold injury include chilblains and chapped skin.... cold injury
All except the mildest electric shocks may result in unconsciousness. Alternating current (AC) is more dangerous than direct current (DC) because it causes sustained muscle contractions, which may prevent the victim from letting go of the source of the current. A current as small as 0.1 of an amp passing through the heart can cause a fatal arrhythmia. The same current passing through the brainstem may cause the heart to stop beating and breathing to cease. Larger currents, generated by high voltages, may cause charring of tissues, especially where the current enters and exits the body. ... electrical injury
The gums become sore and bleed at the slightest pressure. Crater-like ulcers develop on the gum tips between teeth, and there may be a foul taste in the mouth, bad breath, and swollen lymph nodes. Sometimes, the infection spreads to the lips and cheek lining (see noma).
A hydrogen peroxide mouthwash can relieve the inflammation.
Scaling is then performed to remove plaque.
In severe cases, the antibacterial drug metronidazole may be given to control infection.... gingivitis, acute ulcerative
Acute hepatitis is fairly common.
The most frequent cause is infection with one of the hepatitis viruses (see hepatitis, viral), but it can arise as a result of other infections such as cytomegalovirus infection or Legionnaires’ disease.
It may also occur as a result of overdose of halothane or paracetamol or exposure to toxic chemicals including alcohol (see liver disease, alcoholic).
Symptoms range from few and mild to severe with pain, fever, and jaundice.
Blood tests, including liver function tests, may be used for diagnosis.
In most cases of acute viral hepatitis, natural recovery occurs within a few weeks.
If the disorder is caused by exposure to a chemical or drug, detoxification using an antidote may be possible.
Intensive care may be required if the liver is badly damaged.
Rarely, a liver transplant is the only way of saving life.
In all cases, alcohol should be avoided.... hepatitis, acute
Polycystic kidney disease is distinguished from multiple simple kidney cysts, which occur commonly with age.
There are 2 types of polycystic disease.
The most common usually becomes apparent in middle age, producing abdominal swelling, pain, and blood in the urine.
As the disease progresses, hypertension and kidney failure may result.
The rare type causes enlargement of the kidneys and kidney failure in infants and young children.
There is no effective treatment for preserving kidney function in either type, but symptoms of kidney failure can be treated by dialysis and kidney transplant.... kidney, polycystic
Exposure to certain chemicals (such as benzene and some anticancer drugs) or high levels of radiation may be a cause in some cases. Inherited factors may also play a part; there is increased incidence in people with certain genetic disorders (such as Fanconi’s anaemia) and chromosomal abnormalities (such as Down’s syndrome). People with blood disorders such as chronic myeloid leukaemia (see leukaemia, chronic myeloid) and primary polycythaemia are at increased risk, as their bone marrow is already abnormal.
The symptoms and signs of acute leukaemia include bleeding gums, easy bruising, headache, bone pain, enlarged lymph nodes, and symptoms of anaemia, such as tiredness, pallor, and breathlessness on exertion. There may also be repeated chest or throat infections. The diagnosis is based on a bone marrow biopsy. Treatment includes transfusions of blood and platelets, the use of anticancer drugs, and possibly radiotherapy. A bone marrow transplant may also be required. The outlook depends on the type of leukaemia and the age of the patient. Chemotherapy has increased success rates and 6 in 10 children with the disease can now be cured, although treatment is less likely to be completely successful in adults.... leukaemia, acute
Pneumoconiosis is fibrosis of the lung due to inhalation of industrial dusts, such as coal. Asbestosis is associated with asbestos in industry. Allergic alveolitis is caused by organic dusts (see farmer’s lung).
Industrial chemicals can damage the lungs if inhaled, or other major organs if they enter the bloodstream via the lungs or skin. Examples include fumes of cadmium, beryllium, lead, and benzene. Carbon tetrachloride and vinyl chloride are causes of liver disease. Many of these compounds can cause kidney damage. Work-related skin disorders include contact dermatitis and squamous cell carcinoma. Rare infectious diseases that are more common in certain jobs include brucellosis and Q fever (from livestock), psittacosis (from birds), and leptospirosis (from sewage). People who work with blood or blood products are at increased risk of viral hepatitis (see hepatitis, viral) and AIDS, as are healthcare professionals. The nuclear industry and some healthcare professions use measures to reduce the danger from radiation hazards. Other occupational disorders include writer’s cramp, carpal tunnel syndrome, singer’s nodes, Raynaud’s phenomenon, deafness, and cataracts.... occupational disease and injury
Examples include epicondylitis: painful inflammation of one of the bony prominences at the elbow, caused by the pull of the attached forearm muscles during strenuous activities (see golfer’s elbow; tennis elbow).
Overuse injuries of the fingers, thumb, and wrist joints may affect assembly-line and keyboard workers, and musicians; injuries of the neck may affect violinists.
Rest relieves the symptoms.
A change in the technique used during the activity may prevent recurrence.... overuse injury